This two-site (Rush University and Northwestern University) linked re-submission of R34MH100443 collaborative application aims to design a culturally tailored and communityengaged intervention to reduce suicidal thoughts in US Chinese older adults, who have the highest suicide rate than any other racial/ethnic groups. Despite this health disparity, we have great paucity in our understanding of cultural issues surrounding suicide in Chinese populations, and this has directly hampered the intervention efforts. Accordingly, we seek to support a geriatrician (Dong) with expertise in aging, mental health and Chinese culture, and an interventionist (Simon) with expertise in clinical trials using community health workers to reduce health disparities among minority populations. More specifically, we aim to 1) expand synergistic academic and community partnerships;2) iteratively design and refine a culturally meaningful pilot intervention to reduce suicidal thoughts;3) conduct a pilot randomized controlled trial;and 4) rigorously evaluate the cultural acceptability of the proposed intervention at multiple levels. This study will set the cornerstone for the next R01 application to fully test the efficacy of a culturally tailored intervention to reduce suicidal thoughts in Chinese aging populations. By 2030, Chinese older adults will account for a quarter of the world's aging populations. Despite the rapid growth of Chinese populations in the US, there are marked health disparities among Chinese older adults, which are further exacerbated by the complex linguistic and cultural nuances in studying Chinese populations, particularly on issues of suicidal thoughts. Moreover, there has been inadequate and sustainable community support necessary to empower the Chinese community to be fully engaged as equal partners in research. In this application, a bilingual and bicultural principal investigator and an interdisciplinary investigative team have leveraged the principles of community-based participatory research (CBPR), building on our prior NIH funded CBPR projects to partner synergistically and sustainably with the Chicago Chinese community in order to overcome these challenges and set the foundation for this proposal. The study findings will inform clinicians, investigators, communities, social services and policy makers to: a) improve our in-depth understanding of cultural issues surrounding suicide;b) empower community to be equal partners in mental health research;c) guide the next R01 intervention study;and d) inform practice and policy on suicide care in Chinese older adults.

Public Health Relevance

This R34 resubmission will collaborative and iteratively design and refine a culturally adapted intervention to reduce the frequency and intensity of suicidal thoughts in Chinese older adults. This has implication for investigators, clinicians, community, social services and policy makers to reduce suicide in Chinese older adults. This two-site (Rush University and Northwestern University) linked re-submission of R34MH100443 collaborative application aims to design a culturally tailored and communityengaged intervention to reduce suicidal thoughts in US Chinese older adults, who have the highest suicide rate than any other racial/ethnic groups. Despite this health disparity, we have great paucity in our understanding of cultural issues surrounding suicide in Chinese populations, and this has directly hampered the intervention efforts. Accordingly, we seek to support a geriatrician (Dong) with expertise in aging, mental health and Chinese culture, and an interventionist (Simon) with expertise in clinical trials using community health workers to reduce health disparities among minority populations. More specifically, we aim to 1) expand synergistic academic and community partnerships;2) iteratively design and refine a culturally meaningful pilot intervention to reduce suicidal thoughts;3) conduct a pilot randomized controlled trial;and 4) rigorously evaluate the cultural acceptability of the proposed intervention at multiple levels. This study will set the cornerstone for the next R01 application to fully test the efficacy of a culturally tailored intervention to reduce suicidal thoughts in Chinese aging populations. By 2030, Chinese older adults will account for a quarter of the world's aging populations. Despite the rapid growth of Chinese populations in the US, there are marked health disparities among Chinese older adults, which are further exacerbated by the complex linguistic and cultural nuances in studying Chinese populations, particularly on issues of suicidal thoughts. Moreover, there has been inadequate and sustainable community support necessary to empower the Chinese community to be fully engaged as equal partners in research. In this application, a bilingual and bicultural principal investigator and an interdisciplinary investigative team have leveraged the principles of community-based participatory research (CBPR), building on our prior NIH funded CBPR projects to partner synergistically and sustainably with the Chicago Chinese community in order to overcome these challenges and set the foundation for this proposal. The study findings will inform clinicians, investigators, communities, social services and policy makers to: a) improve our in-depth understanding of cultural issues surrounding suicide;b) empower community to be equal partners in mental health research;c) guide the next R01 intervention study;and d) inform practice and policy on suicide care in Chinese older adults.